Surgery: light – thermal – and electrical application – Light – thermal – and electrical application – Electrical therapeutic systems
Patent
1993-11-17
1995-07-11
Kamm, William E.
Surgery: light, thermal, and electrical application
Light, thermal, and electrical application
Electrical therapeutic systems
A61N 1365
Patent
active
054316901
DESCRIPTION:
BRIEF SUMMARY
BACKGROUND OF THE INVENTION
1. Field of The Invention
The invention relates to a medical device of the type for generating a therapeutic value for a patient as a function of at least one variable parameter picked up within the body and constituting a first input value, with a change in the first parameter being a function of a second parameter which also constitutes an input value.
2. Background Information
In such devices which generate a therapeutic value for a patient from a value (parameter) picked up within the patient's body, there often exists the problem that this parameter, with the aid of which the patient is treated, is a function of another parameter about which no reliable knowledge is available in connection with the intended treatment to enable it to be used as a further variable in the course of the treatment or which cannot be considered for other reasons. Since the further parameter thus takes on a relatively random value in each case, success of the treatment cannot be ensured with the necessary reliability.
Thus, it has not yet been possible in connection with cardiac pacemakers to provide a reliable rule for influencing the stimulation rate with maximum efficiency as a function of conductivity values that were picked up in the heart within the cardiac cycle at certain points in time during the pre-ejection period.
The obtained values differed greatly from patient to patient so that the transfer of settings found for one patient to another patient was increasingly connected with difficulties.
Usually it was the increase in conductivity that was evaluated, determined by electrodes installed in the right ventricle which preferably may simultaneously constitute electrodes of the stimulation system.
SUMMARY OF THE INVENTION
It is the object of the invention to make it possible, in a medical device of the above-mentioned type, to influence in such a way the acquisition conditions for the parameter that controls a therapeutic value and is picked up within the patient's body that the sensitivity of the control or regulation becomes a maximum and, in particular, the regulation algorithms to be employed for various patients can be transferred to other patients.
This is accomplished by means for varying the generation of the therapeutic value by varying the second parameter so that the difference of the values of the first parameter, at selected limits of a variation range of the first parameter, constitutes a maximum in an intended treatment range of the patient, a memory in which a value of the second parameter for which the variation range of the parameter constitutes a maximum is retained; and a control means for changing the therapeutic value as a function of the first parameter while maintaining the previously stored second parameter.
The invention is based on the realization that often there are one or several further parameters which influence the acquisition of the parameter to be evaluated in an undetected manner. If it is now possible to set this parameter for the measurement in such a way that the change in the parameter to be evaluated becomes a maximum in the intended treatment range for the patient, the information available for a change in the value influencing the treatment of the patient can in many cases be significantly improved or discovered at all.
Thus, a further parameter in the form of another value that influences the patient is changed by means of suitable measures in such a way that the influencing of physical processes within the patient is maximized as a function of a first value derived from the body so that maximum response to the treatment is ensured. This maximization of the influenceability of the patient is determined during a "learning cycle" of the device and the determined result is then used for the further treatment.
In the medical device of this type for generating a therapeutic value for a patient as a function of at least one first parameter picked up within the body it is initially assumed that the first parameter is a function of a further (second
REFERENCES:
patent: 4280502 (1981-07-01), Baker, Jr. et al.
Hastings David
Kulp Barry D.
Schaldach Max
Biotronik Mess- und Therapiegerate GmbH & Co. Ingenieurburo Berl
Getzow Scott M.
Kamm William E.
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